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Biomedical subjects

M R Robinson

Publications and source records attributed to M R Robinson.

At least 109 records · Page 6Linked to original sources
PubMed1981

Cardiovascular complications in the treatment of prostatic carcinoma.

Cardiovascular complications in patients with carcinoma of the prostate have been studied in relation to 3 methods of treatment, namely stilboestrol, estramustine phosphate (Estracyt) and bilateral orchiectomy. One hundred and sixteen patients were studied over a 4-year period on a prospective basis, 48 being treated with stilboestrol, 31 with estramustine and 37 with bilateral orchiectomy. The incidence of the cardiovascular side effects of these 3 treatment regimes in the first year of treatment was recorded after the patients had been divided into those with localised (MO) disease and advanced disease with metastases (M1). In patients treated with stilboestrol 29% had cardiovascular complications with a mortality rate of 16%. With estramustine 25% had complications with a 16% mortality rate, but with orchiectomy the complication rate was only 8% with a 3% mortality rate. It is recommended that stilboestrol and estramustine phosphate should not be used in the presence of cardiovascular disease and that the primary form of treatment in prostatic carcinoma should be bilateral orchiectomy, especially in patients with localised disease.

Aged↗
PubMed1980

Bacteriaemia and bacteriogenic shock in district hospital urological practice.

The incidence of bacteriaemia and bacteriogenic shock was studied in 2 series of patients undergoing urological procedures. In the first series (A), 52 of 4333 urological patients had symptoms of bacteriogenic shock. Twenty-five of these had a positive blood culture, giving an incidence of shock with proven bacteriaemia of 0.58%. In the second series (B) 628 patients had blood cultures taken after urological procedures with an incidence of bacteriaemia of 12.7%. Bacteriaemia is most common after prostatic surgery (transurethral prostatectomy 2.7%, retropubic, prostatectomy 37%, prostatic biopsy 20%), and is usually due to Esch. coli, Proteus species and Ps. aeruginosa. In hospital practice these organisms are unlikely to be sensitive to common antibiotics and initial therapy with an aminoglycoside is justified, while awaiting the results of blood culture.

Adult↗
PubMed1979

Effects of tamoxifen on the binding and metabolism of testosterone by human prostatic tissue and plasma in vitro.

The in-vitro metabolism of testosterone in benign and malignant prostatic tissue was examined and distinct quantitative differences between the two types of specimens were observed. The major metabolite of testosterone in the hyperplastic prostate was 5 alpha-dihydrotestosterone and a high 3 alpha(beta)-hydroxysteroid dehydrogenase activity was also detected. In the malignant tissue, 5 alpha-reductase activity was considerably reduced and there was little or no androstanediol formed; the 17 beta-dehydrogenase activity was, however, higher than in the benign tissue. The decrease in 5 alpha-reductase was always followed by a compensatory change in the 3 alpha(beta)-hydroxysteroid dehydrogenase of the malignant prostate. The present study revealed that the ratio of the mean activities of 5 alpha-reductase to 3 alpha(beta)-hydroxysteroid dehydrogenase in the two types of specimen always remained a constant. Although the antioestrogen, tamoxifen, induced an inhibitory effect on the activities of 5 alpha-reductase and 17 beta-hydroxysteroid dehydrogenase in the gland, the present investigation also suggested that tamoxifen stimulated the activity of 3 alpha(3 beta)-hydroxysteroid dehydrogenase. In blood, the action of tamoxifen appeared to be confined to the displacement of androgens from the binding sites on the sex hormone binding globulin.

Aged↗
PubMed1978

Prostate carcinoma: intratumor BCG immunotherapy.

Two groups of patients with advanced cancer of the prostate received adjuvant immunotherapy by direct intra-tumor injection of BCG. The first group had advanced metastatic disease that was failing to respond to conventional hormone therapy. The second group were new cases of stages III and IV tumor who were previously untreated and who had had a transurethral resection of the prostate and orchiectomy followed by BCG immunotherapy. The clinical and pathologic findings for both groups of patients are described.

BCG Vaccine↗
PubMed1977

Intravesical epodyl in the management of bladder tumors: combined experience of the Yorkshire Urological Cancer Research Group.

Of 48 patients with bladder tumors treated with intravesical epodyl 17 have shown a complete remission at some stage of treatment, although several have relapsed later. Partial remission occurred in 20 patients and 11 have shown no improvement or the lesions have progressed. Epodyl is used best as an adjunct to transurethral resection or diathermy of T1 bladder lesions. Even in patients who do not show complete remission epodyl may reduce the incidence of recurrence and the number of lesions. It is useful when rapid recurrence of T1 bladder tumors prevents control by resection or diathermy and it also is beneficial as an emergency measure to control hematuria. Complications are not infrequent and may be severe occasionally. Bone marrow depression has been seen in 2 patients whose bladders showed extensive carcinoma in situ.

Adult↗
PubMed1977

Adjuvant immunotherapy with B.C.G. in carcinoma of the prostate.

8 previously untreated patients with Stage III and Stage IV prostatic cancer who had had the bulk of their primary tumour removed by transurethral resection, and residual tumour suppressed by bilateral total orchidectomy, were given adjuvant immunotherapy by direct injection of B.C.G. into the prostate. The pyrexial reaction to, and the histological changes from B.C.G. have been more marked in the patients whose disease is no longer controlled by conventional therapy. Granulomas have been found in the lungs, liver, myocardium, spleen and bone marrow. Granulomas in carcinomatous areas have been associated with tumour cell degeneration.

Aged↗
PubMed1977

The treatment of advanced carcinoma of the bladder with a combination of adriamycin and 5-fluorouracil.

52 patients with advanced bladder cancer, no longer controlled by conventional therapy, have been treated by combination chemotherapy with Adriamycin and 5-fluorouracil. The objective remission rate has been 40%. The morbidity of the chemotherapy has not been excessive. The response has not been related to the histological grade of the primary tumour and previous treatment. Patients with a good performance status (Karnofsky index) have responded better than those with a poor performance status.

Doxorubicin↗